Tonsillotome



J. T. MOORE TONSILLOTOME April 16, 1940.

Filed Feb. 25, 1937 .-l TTURA'EY Patented Apr. 16, 1940 7' *PAT ENTOFFICE TONSILLOTOME John Terrell Moore, Tampa, Fla. Application February25, 1937, Serial No. 127,705

4 Claims.

Thisinvention relates to instruments of the surgical snare typeespecially adapted for removing tonsils.

The primary object of the invention is to provide a device in which thetonsil hook lies within the loop of the snare and cooperates with the amember that carries the snare to maintain it in operative positionduring the preliminary dissection freeing the tonsil from the anteriorpillar. Another object of the invention is the provision of a devicewhich is easy to operate, light in weight, smooth and efficient inoperation, and not likely to get out of order. A further object of theinvention is the provision of a small number :of parts which are readilydetachable to permit easy and thorough cleaning and sterilization.

In the drawing, Figure 1 is a plan view of the entire device assembled;Fig. 2 is a similar plan view of the tonsil hook with the snare bar and.

the counterpressure bar removed; Fig. 3 is a side elevation with partsin section of the assembled device with the elements in the samerelative positions'as in Fig. 1; Fig. 4 is a plan view of the oppositeface of the counterpressure bar from that shown in Fig. 1; Fig. -5 is aplan view of the snare bar; Fig. 6 is a plan view of the snare; and Fig.7 is an end view of the retention clip.

A counterpressure bar I has a thumb loop 2 at one end and an inclinedguide portion 3 at the other endprovided with a passageway therethroughindicated in broken lines at 4 in Fig. 4 for the reception of a snare 5shown in plan in Fig. 6 and in side elevation in Fig. 3. The snare has alongitudinal slot near one end and an aperture 1 near the other end,shown in Fig. 6 as circular and concentric with a curved front end i B.The material of the snare willpreferably be of an alloy such asstainless steel which will be strong, light, resilient, durable, andeasily sterilized.

A snare bar 9 has at one end 2. lug l0 having in its front end a notch Hto receive the portion of the snare at the front end of the slot 6, thisnotch ll being deep enough to permit the snare to slide rearward to apoint at which the rear end of the slot will clear the rear end of thelug to permit the snare to be bent down behind the rear end 12 ofthe'lug which has a notch 13 into which the snare can be slid forwarduntil the V-shaped notch 14 in its rear end can move down. in front ofthe front end l5 of the snare bar. The rear notch I3 is not as deep asthe front notch ll and the snare cannot slide forward enough todisengage from the lug at its front end. Its resiliency will retain itin the twonotches and it cannot slide backward while the notch I4 is incontact with the V-shaped front end l'5 of the snare bar. This form ofengagement also serves to prevent angular lateral movement of the snareon the lug l0. I

The snare bar has two finger loops "5 and I! which project laterally,one on each side of the bar.

The counterpressure bar'l has two longitudinal slots l8 and I9, and thesnare bar has a relatively short slot 20 which lies opposite the slot I8to receive the head 2| of a T-shaped lug 22 on a. retention clip 23shown in end view in Fig. 7. With the clip held at right angles to thebars I and 9, the'head 2| can be passed through the slots l8 and 20 andthen turned to bring the body of the c1ip p-aralle1 with the bars withthe ends of the head 2| at each side of the slot 20 where it may be heldin position by .a screw 24 passed through a hole in the clip and securedin a threaded socket '25 formed in the bar 9. The bars I and 9 will beheld together by the clip 23 with its lug 22 and screw 24 free to slidelongitudinally of the slots l8 and 19 in the bar I, the ends of theslots acting as stops to limit sliding movement of the snare bar on thecounterpressure bar in both forward and rearward directions.

The snare bar, at its limit of forward movement, does not reach theguide portion 3 of the counterpressure bar, but the snare 5 will be ofthe proper length to cause the entire aperture 1 to project beyond thefront end of the portion 3 at its limit 'of forward movement, and theslots 18 and I9 will be of such lengththat the entire aperture 1 will bewithdrawn into the guide por tion 3 through the'opening 4 at therearward limit of sliding movement of the snare bar.

The tonsil' hook member 26 has hooks 2! formed on its front end, andatits rear or handle end, it has two flanges 28 and 29 spaced far enoughapart to receive the body portions of the bars I and 9 and of a lengthto extend from the rear ends of the finger loops l6 and I! to the frontend of the thumb loop 2 when the bar 9 is bar I if the front ends of theflanges should become disengaged from the finger loops.

The hook member is curved inward at 34 adjacent to the portion 8 of thesnare in its forward position and the curvature of the inclined endportion 3 holds the snare outward beyond the curved portion of the hookwhenthe bars I and 9 lie within the flanges 28 and 29. In the normaloperation of the device, the hook will extend only a little distancebeyond the front end of the snare loop, but the shaft of the hook willbe surrounded by the loop.

The snare 5 will first be engaged with the lug- I!) of the snare bar andthen will be slid through the passageway 4 in the guide portion 3 "ofthe counterpressure bar. When the two bars I and 9 are placed togetherwith either face of the bar 9 lying in contact with the bar I, the lug22 of the retention clip will be passed through the slots It and 20 andthe clip will then be turned to bring the head 2 I at right angles tothe slots, with the ends of the head engaging the bar at theopposite-sides of the slot I8. The screw 24 will then be passed throughslot I 9 into the socket 25, and the two bars are then ready forrelative sliding movement. With theend of the bar I held with theinclined portion 3 turned toward the hooks 21, the member 26 will beinserted through the aperture I and the flanges will then be placed inpositionbetween the thumb and finger loops as shown in Fig. 1.

, The operator willgrasp the handle of the hook member in one hand, thusholding the bars I and 8 in the recess between the flanges, and willtake hold of the tonsil toberemoved with the hooks. While held by thehooks, the tonsil is dissected loose from the anterior pillar with ascalpel until the snarecan be slid oif the hook around the tonsil. Theflanges 28 and 29 will then be removed from between the thumb loop 2 andthe finger loops l6 and I1 to permit relative movement of these loopstoward each other. When the snare has been moved into position aroundthe tonsil, the operator inserts fingers and thumb in the loops anddraws the snare into the guide member, severing the remainingattachments of the tonsil by crushing them off against the blunt bladeformed by the end of the guide portion 3. The inside of the loop portion8 of the snare is preferably rounded so that it will crush the tissuesinstead of cutting them, to minimize the danger of hemorrhage.

It will be understood by those skilled in the art that the structuresillustrated may be modified inimany details without departure from thespir it of the invention as claimed;

I claim:

1. A surgical-instrument comprising a counterpressure bar having apassageway formed therein, a snare bar slidably mounted upon thecounterpressure bar and having a snare thereon projecting through saidpassageway, finger loops upon one bar and a thumb loop upon the otherbar, and a hook member having flanges adapted to receive the said barsand to engage the said loops to prevent sliding movement of either barupon the other.

2. A surgical instrument comprising a counterpressure bar having a guidemember at its forward end formed with a passageway to guide the slidingmovement of a snare, a snare bar and a snare attached thereto forsliding movement within the said passageway and having a loop projectingbeyond the said passageway, and

means for guiding and limiting the sliding move- I ment of the snare barupon the counterpressure bar, and ahook member adapted to engage thesaid bars to prevent their relative sliding movement 'and'having a hookportionadapted to extend through the loop-of the snarewhile in engagement with said bars.

3. A surgical instrument comprising accounterpressure bar and a snarebar :connected for relative sliding movement, thecounterpressure barhaving its forward end inclined at an angle to its longitudinal axis andprovided with a pas-' sageway for a snare, a flexible snare having aloop'and detachably connected with the snare bar I for sliding movementthrough. the inclined passageway, and a .hookmember: provided with ahook at its forward end-and curved to pass through the loop of the snareand having its bandle portion adapted -for engagement with the snare barand the counterpressure bar toprevent sliding movement of either uponthe other.-

4. A surgical instrument comprising a thin flexible .element having a'longitudinalslot within its length and a notch at one end,"anda-support-for said element having a lug toreceive said element,

the lug being provided with a'notch in its for-- ward end of suficientdepth to permit the-por tionof the flexible element in front of theslot'willextend beyond the rearend of the 'lug'to' permit the lug to entertheslot, and the lug. be-

to be lslid rearward until the rear end of the slot ing provided :with anotch for the reception of the :flexibleelement in its rear end of lessdepth than the front slot whereby the flexible element may slide forwardon the lug while engaged with both notchesand thesupport for theflexible ele-'- ment'having a-detent portion behind the rear notch inthe lug of greaterheight than the rear notch and at a distance from thelug to permit the rear end of the flexible element to spring downbetween the lug and the detent portion;

' JOHN TERRELL MOORE)

